Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for instructions and the latest information.
| (i) Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 10 above (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
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Total |
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Calendar year
(or fiscal year beginning in)
![]() |
(a) 2019 | (b) 2020 | (c) 2021 | (d) 2022 | (e) 2023 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | 407,771 | 451,815 | 404,953 | 486,990 | 300,230 | 2,051,759 |
| 2 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf .... | ||||||
| 3 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 4 | Total. Add lines 1 through 3 | 407,771 | 451,815 | 404,953 | 486,990 | 300,230 | 2,051,759 |
| 5 | The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f) .. | 166,545 | |||||
| 6 | Public support. Subtract line 5 from line 4. | 1,885,214 | |||||
Calendar year
(or fiscal year beginning in)
![]() |
(a) 2019 | (b) 2020 | (c) 2021 | (d) 2022 | (e) 2023 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 407,771 | 451,815 | 404,953 | 486,990 | 300,230 | 2,051,759 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | 1 | 1 | ||||
| 9 | Net income from unrelated business activities, whether or not the business is regularly carried on.. | ||||||
| 10 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.).. | ||||||
| 11 | Total support. Add lines 7 through 10 | 2,051,760 | |||||
Calendar year (or fiscal
year beginning in) ![]() |
(a) 2019 | (b) 2020 | (c) 2021 | (d) 2022 | (e) 2023 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | ||||||
| 2 | Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose | ||||||
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513 ..... | ||||||
| 4 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... | ||||||
| 5 | The value of services or facilities furnished by a governmental unit to the organization without charge | ||||||
| 6 | Total. Add lines 1 through 5 | ||||||
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons | ||||||
| b | Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year. | ||||||
| c | Add lines 7a and 7b.. | ||||||
| 8 | Public support. (Subtract line 7c from line 6.) | ||||||
Calendar year
(or fiscal year beginning in)
![]() |
(a) 2019 | (b) 2020 | (c) 2021 | (d) 2022 | (e) 2023 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | ||||||
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | ||||||
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | ||||||
| 11 | Net income from unrelated business activities not included on line 10b, whether or not the business is regularly carried on. | ||||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) .. | ||||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | ||||||
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e |
Discount claimed for blockage or other factors (explain in detail in Part VI): |
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| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 0.015 of line 3 (for greater amount, see instructions). | 4 | ||||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | ||||
| 6 | Multiply line 5 by 0.035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | 1 | |
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
2 | |
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | 3 | |
| 4 Amounts paid to acquire exempt-use assets | 4 | |
| 5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI) | 5 | |
| 6 Other distributions (describe in Part VI). See instructions | 6 | |
| 7Total annual distributions. Add lines 1 through 6. | 7 | |
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
8 | |
| 9 Distributable amount for 2023 from Section C, line 6 | 9 | |
| 10 Line 8 amount divided by Line 9 amount | 10 | |
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2023 |
(iii) Distributable Amount for 2023 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2023 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2023 (reasonable cause required-- explain in Part VI).
See instructions. |
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| 3 Excess distributions carryover, if any, to 2023: | ||||
| a From 2018....... | ||||
| b From 2019....... | ||||
| c From 2020....... | ||||
| d From 2021....... | ||||
| e From 2022....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2023 distributable amount | ||||
|
i
Carryover from 2018 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from line 3f. | ||||
| 4Distributions for 2023 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2023 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from line 4. | ||||
|
5
Remaining underdistributions for years prior to 2023, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions. |
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6
Remaining underdistributions for 2023. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions. |
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7 Excess distributions carryover to 2024. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2019..... | ||||
| b Excess from 2020..... | ||||
| c Excess from 2021..... | ||||
| d Excess from 2022..... | ||||
| e Excess from 2023..... | ||||
| Facts And Circumstances Test |
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| Return Reference | Explanation |
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| Software ID: | |
| Software Version: |
| Return Reference | Explanation |
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| FORM 990, PAGE 2, PART III, LINE 4A | GIVEHEAR (A DBA OF HEARCARE CONNECTION) WAS FOUNDED TO ELIMINATE THE ACCESS GAP FOR QUALITY HEARING HEALTHCARE AVAILABLE TO THE UNDERSERVED IN OUR COMMUNITY. OUR PROGRAM IS UNIQUE AND UNDUPLICATED BY ANY OTHER AGENCY IN NORTHEAST INDIANA. ESTABLISHED IN 2011, GIVEHEAR HAS SERVED OVER 7,700 PATIENTS ACROSS A DIVERSE DEMOGRAPHIC. WE ARE COMMITTED TO GROWING OUR SERVICE REACH TO THE UNDERSERVED AND IMPLEMENTING PROGRAMS AS NEEDED TO ELIMINATE ACCESS DESERTS FOR NEEDED AUDIOLOGY SERVICES. PROGRAMS: IN 2023, GIVEHEAR SERVED 1,514 UNIQUE PATIENTS, ACQUIRED 1,067 NEW PATIENTS, AND COMPLETED 2,801 TOTAL APPOINTMENTS. IN 2023, GIVEHEAR INSTALLED A SECOND AUDIO BOOTH AT ITS MAIN SITE IN DOWNTOWN FORT WAYNE TO INCREASE ITS CAPACITY FOOTPRINT. THIS ALLOWED US TO ACCOMMODATE GROWTH IN OUR SERVICE TO THE COMMUNITY. HEARING ASSESSMENT PROGRAM: ENCOMPASSES DIAGNOSTIC ASSESSMENT OF HEARING FUNCTION USING STATE-OF-THE-ART EQUIPMENT, WHICH IS APPROPRIATE FOR PATIENTS OF ANY AGE AND FUNCTIONAL ABILITY. GIVEHEAR RECEIVES ASSESSMENT REFERRALS FROM OTHER AREA HEALTHCARE PROFESSIONALS, INDIANA'S EARLY INTERVENTION PROGRAM FIRST STEPS, ORGANIZATIONS ASSISTING VETERANS, OTHER NONPROFIT AGENCIES, AND BY SELF-REFERRAL. HEARING AID REHABILITATION PROGRAM: ENCOMPASSES THE SELECTION, FITTING, FOLLOW-UP, AND MAINTENANCE OF NEW OR DONATED HEARING AIDS. PATIENTS QUALIFY FOR THIS PROGRAM ACCORDING TO ADJUSTED HOUSEHOLD INCOME AND PAY FOR A PORTION OF THEIR DEVICE COST BASED ON OUR REDUCED SLIDING FEE SCALE. GIVEHEAR FIT 403 HEARING AIDS IN 2023. CIRCLE OF GIVING: GIVEHEAR HEARING AID RECIPIENTS ON OUR SLIDING FEE SCALE COMPLETE A SET NUMBER OF VOLUNTEER SERVICE HOURS AT A NONPROFIT AGENCY WITHIN THEIR COMMUNITY TO GIVE BACK VIA VOLUNTEERISM. BECAUSE GIVEHEAR RELIES ON COMMUNITY SUPPORT TO EXECUTE OUR MISSION, OUR PATIENTS GIVE BACK TO THE COMMUNITY THAT SUPPORTS US AND MAKES THEIR HEARING HEALTHCARE POSSIBLE. HEARING AID DONATION PROGRAM: WE COLLECT GENTLY USED HEARING AIDS THAT CAN BE RECONDITIONED AND REPROGRAMMED FOR OUR PATIENTS. THIS PROGRAM SERVES MANY OF OUR HEARING AID RECIPIENTS AND GIVES AN OPPORTUNITY FOR THE COMMUNITY TO REHOME USED HEARING AIDS TO OUR CLINIC. NEWBORN HEARING PROGRAM: PROVIDES AFFORDABLE, PRICE-CAPPED FOLLOW-UP DIAGNOSTIC TESTING FOR BABIES WHO FAIL OR DO NOT RECEIVE A NEWBORN HEARING SCREENING AT BIRTH. USING OUR HIGHLY SPECIALIZED EQUIPMENT, 258 BABIES WERE TESTED IN 2023 THROUGH OUR PARTNERSHIPS WITH LOCAL HOSPITALS, BIRTHING CENTERS, AND MIDWIVES. SCHOOL SCREENING PROGRAM: PROVIDES ONSITE HEARING SCREENINGS, PRIMARILY PRESCHOOL-AGED CHILDREN ATTENDING EARLY EDUCATION PROGRAMS FOR LOW-INCOME FAMILIES AND/OR CHILDREN WITH SPECIAL NEEDS. IN AN EFFORT TO IDENTIFY HEARING LOSS AS EARLY AS POSSIBLE, GRANT FUNDED FOLLOW-UP TESTING IN OUR CLINIC IS ALSO OFFERED FOR CHILDREN WHO DO NOT PASS THE ONSITE SCREENING. PARTNERSHIPS WITH BRIGHTPOINT HEAD START, PUBLIC AND PRIVATE PRESCHOOL PROGRAMS, AND LIONS CLUB. SCREENED 715 CHILDREN IN 2023. CANCER TREATMENT AND HOSPICE LOANER PROGRAMS: PARTNERSHIPS WITH CANCER SERVICES OF NORTHEAST INDIANA, HEARTLAND HOSPICE, AND STILLWATER HOSPICE ALLOW US TO PROVIDE HEARING AIDS FOR PATIENTS UNDERGOING CANCER TREATMENT OR IN HOSPICE CARE. THE LOANED HEARING AIDS FOSTER IMPROVED COMMUNICATION WITH FAMILY, CAREGIVERS, AND COMMUNITY. SERVED 6 PATIENTS IN 2023. GIVEHEAR IS UNIQUE. THERE ARE NO OTHER SIMILAR PROGRAMS TO OURS IN THE REGION. ONLY A HANDFUL OF SIMILAR PROGRAMS EXIST NATIONALLY, SOME OF WHICH GIVEHEAR HELPED DEVELOP AT THE REQUEST OF THOSE COMMUNITIES. THE EFFECTS OF UNDIAGNOSED AND/OR UNTREATED HEARING LOSS ARE SIGNIFICANT, DETRIMENTAL, AND CAN BE MITIGATED OR ELIMINATED WITH APPROPRIATE, QUALITY HEARING HEALTHCARE. HEARING AIDS ARE A HIGHLY EFFECTIVE, YET COSTLY TOOL TO COUNTERACT THE NEGATIVE IMPACT OF MOST HEARING LOSSES. THEY ARE DESIGNED TO IMPROVE SOUND LOCALIZATION, LISTENING IN NOISY SITUATIONS, SPEECH UNDERSTANDING, AND PROVIDE BETTER OVERALL HEARING. IN FACT, 80% OF HEARING LOSSES CAN BE EFFECTIVELY REHABILITATED USING HEARING AIDS. ACCORDING TO THE AMERICAN SPEECH LANGUAGE HEARING ASSOCIATION (ASHA), LESS THAN 25% OF PEOPLE WHO COULD BENEFIT FROM HEARING AIDS ACTUALLY HAVE THEM. OFTENTIMES, COST IS THE LIMITING FACTOR. THESE ISSUES ARE AT THE HEART OF THE SERVICES GIVEHEAR PROVIDES TO OUR COMMUNITY. OUR CLINICS PROVIDE HEARING SCREENINGS, HEARING TESTS, HEARING AIDS AND RELATED ACCESSORIES, HEARING AID MAINTENANCE AND REPAIRS, AND FOLLOW UP CARE TO INDIVIDUALS WHO OTHERWISE WOULD NOT HAVE ACCESS TO THESE SERVICES. FEES FOR HEARING AID SERVICES ARE BASED ON A SLIDING FEE SCALE ACCORDING TO FAMILY SIZE AND INCOME, AND WE PRIMARILY SERVE INDIVIDUALS UP TO 400% OF THE FEDERAL POVERTY LEVEL. IN ADDITION TO OUR NOMINAL FEES, WE REQUIRE OUR FINANCIALLY QUALIFIED PATIENTS TO COMPLETE A SET NUMBER OF VOLUNTEER SERVICE HOURS AT A NONPROFIT AGENCY WITHIN OUR COMMUNITY. THIS VOLUNTEERISM HELPS REDUCE SOCIAL ISOLATION, ENSURES THEY ARE INVESTED IN THEIR OWN HEARING HEALTHCARE, PROMOTES SELF-SUFFICIENCY, AND BUILDS FEELINGS OF SELF-WORTH. THIS IS OUR "CIRCLE OF GIVING" PROGRAM. IN ADDITION TO HEARING AID SERVICES, GIVEHEAR ALSO CONNECTS WITH OUR COMMUNITY VIA OUTREACH EFFORTS, PROVIDING HEARING SCREENINGS AT SCHOOLS AND HEALTH FAIRS. WE HAVE IDENTIFIED ACCESS DESERTS FOR CERTAIN SUBSPECIALTY AUDIOLOGY SERVICES AND OFFER THOSE SERVICES LOCALLY, ENSURING THAT THE COMMUNITY HAS REGIONAL ACCESS TO A MORE COMPREHENSIVE ROSTER OF AUDIOLOGY SERVICES. |
| FORM 990, PAGE 6, PART VI, LINE 11B | FORM 990 WILL BE REVIEWED AND APPROVED BY THE BOARD TREASURER, THE FINANCE COMMITTEE, AND EXECUTIVE DIRECTOR BEFORE BEING SUBMITTED TO THE IRS. THE BOARD OF DIRECTORS WILL ALSO BE PROVIDED WITH A COPY OF THE FORM 990 PRIOR TO FILING. |
| FORM 990, PAGE 6, PART VI, LINE 12C | ANY BOARD MEMBER WITH AN INTEREST IN THE TOPIC UP FOR VOTE PRESENTS INFORMATIN AND THEN RECUSES HIMSELF/HERSELF FROM THE DISCUSSION AND THE VOTE. DUE DILIGENCE IS PRACTICED BY GETTING MULTPLE QUOTES FOR SERVICES IF A CONFLICT OF INTEREST EXISTS. |
| FORM 990, PAGE 6, PART VI, LINE 15A | THE NORTHEAST INDIANA NONPROFIT SALARY SURVEYS ARE USED AS A GUIDE TO DETERMINE EXECUTIVE DIRECTOR SALARY WHICH IS REVIEWED AND APPROVED BY THE EXECUTIVE COMMITTEE. |
| FORM 990, PAGE 6, PART VI, LINE 18 | THE ORGANZIATIONS FORM 990 IS AVAILABLE AT GUIDESTAR.ORG AND IRS.GOV |
| FORM 990, PAGE 6, PART VI, LINE 19 | THE OGANZIATION MAKES ITS GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS AVAILABLE AT WWW.GUIDESTAR.ORG AND UPON REQUEST. THE ORGANZIATION MAKES ITS CONFLICT OF INTEREST POLICY AVAILABLE UPON REQUEST. |
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